Provider Demographics
NPI:1942684881
Name:GREGORY T JEHRIO MD LLC
Entity type:Organization
Organization Name:GREGORY T JEHRIO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:JEHRIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-439-0202
Mailing Address - Street 1:393 DAVISON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-4004
Mailing Address - Country:US
Mailing Address - Phone:716-493-0202
Mailing Address - Fax:
Practice Address - Street 1:393 DAVISON RD
Practice Address - Street 2:SUITE A
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-4004
Practice Address - Country:US
Practice Address - Phone:716-493-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201352207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty